김 할머니 사건에 대한 대법원 판결의 논거 분석과 비판: “자기결정권 존중”과“최선의 이익”충돌 문제를 중심으로

Abstract

Korea Supreme Court’s case of Grandma Kim is an importantcornerstone for the withdrawal of life-sustaining treatment in a relativelyshort history of Bioethics in Korea. The Court’s decision has its significancein that it declares, in principle, a patient’s right of self-determination onhis/her treatments. However such a right should be very carefully exercisedunder a very restricted circumstance. The Court shows that when a patienthas been in the irreversible procedure of dying, his/her withdrawal of lifesustainingtreatment is allowed with the satisfaction of some qualification. But the Court takes a mistake in mentioning the irreversible consciousnessas an element of the irreversible procedure of dying. The Court accepts notprolonging the end point of death on the basis of the conception of naturaldeath. However, the Court does not fully develop the logic of theconception and also appeals to the principle of respect for selfdetermination. This reveals that the Court does not fully understand thelogical implications of the principle of respect for self-determination. Thisproblem results in restricting the scope of self-determination. Thus, theCourt’s argument is totally different from those of Quinlan’s case andCruzan’s case in America, which focus on the principle of respecting forautonomy. Although the Court finally follows substituted judgment standard,it appeals to both best interests for a patient and respect for self-determination with the misuses of these principles. In addition, the Court’sdecision shows its limitation in that it deals with one of issues related to lifesustainingtreatment, that is, the issue of artificial respiratory device alone.